Pressure Bandage

ABSTRACT

A pressure bandage including an elastic sheet having a first coefficient of elasticity and an adhesive side. The pressure bandage may also include a resilient pad having a second coefficient of elasticity and affixed to the adhesive side of the elastic sheet. The elastic sheet has a first predetermined shape that is configured to be applied to a corresponding anatomical location on the body of a patient. The first coefficient of elasticity and the second coefficient of elasticity are related such that, when the elastic sheet is stretched and adhered to the body of the patient, the resilient pad applies a predetermined amount of pressure to the body of the patient.

CROSS-REFERENCE TO RELATED APPLICATION(S)

This application is a continuation of U.S. application Ser. No.16/249,375, filed Jan. 16, 2019, and entitled “Pressure Bandage,” whichclaims priority to U.S. provisional application No. 62/618,072, filedJan. 16, 2018. The disclosures of the applications listed above areincorporated herein in their entirety.

BACKGROUND OF THE INVENTION 1. Field of the Invention

The present invention relates to pressure bandages and, moreparticularly, to pressure bandages configured for use in particularanatomic locations.

2. Description of Related Art

Different types of wound dressings serve various functions, includingprotecting the wound from trauma and contamination, reducing the risk ofpostoperative hematoma and seroma formation, providing compression ofdead space, preventing heat and fluid loss, absorbing exudate, limitingwound disruption, and providing an aesthetically pleasing appearance.Since no single dressing exemplifies all of these attributes, thecharacteristics of a particular wound determine which of these functionsare required of the dressing.

A “pressure dressing” is a dressing including a bulky component, such asa sponge or gauze pad, and at least one thin strip of material that maybe applied to the body to press the bulky component against the woundsite. The strip of material may include elastic or inelastic materials.When the strip of material is affixed to the patient, it is pulledtightly such that it forces the bulky component against the wound site.Application of a pressure dressing over a wound is intended to compressdead space and prevent hematoma and seroma formation. A pressuredressing can improve hemostasis by preventing capillary blood loss andexudate.

Pressure dressings may be applied to any type of wound, including traumawounds, surgical wounds, or any other type of wound to which it isdesirable to apply pressure. In some cases, pressure dressings areapplied to medical device implantation surgical sites. For example,devices like pain pumps, pacemakers, and other devices are implanted insurgical “pockets” under the skin. Creating the surgical pocket istraumatic to the tissues surrounding the implanted device. Therefore apressure dressing is used to minimize hematoma and seroma at theimplantation site. Among other benefits, minimizing hematoma and seromamay promote healing and may also minimize the risk of infection. Thereis a need to prevent infection particularly in surgical pockets becausea high percentage of pocket infections have poor outcomes.

To improve hemostasis, a pressure dressing may be used to at leastpartially collapse the capillary vessels in the subcutaneous tissues inorder to allow platelet aggregation, plug formation, and formation of afibrin clot. Similarly, exudate in subcutaneous tissue is determined bya combination of oncotic and hydrostatic pressure. Thus, pressuredressings may also be used to decrease seroma formation from exudate.

In many cases, pressure dressings are assembled in an ad-hoc fashionwith multiple strips of tape, which may or may not be elastic, appliedover a stack of gauze that has been centered on top of a wound. Thus,the clinician typically must tediously gather the components toconstruct a conventional pressure dressing and then assemble thedressing on the patient. For example, the clinician must pre-cut severalstrips of tape, place a stack of sponges, gauze, or other paddingelements over the surgical pocket, and then apply the tape over thesponges while balancing the stack of sponges. If the clinician opts notto pre-cut the tape before the surgery, the process of applying themakeshift pressure dressing after the surgery can take even longer.Further, in some cases, the clinician applies additional tape strips tohold the ends of the initial tape strips down or they may use additionalstrips of tape to make the dressing pseudo-waterproof. Regardless of thechosen method for constructing and applying a makeshift dressing, theprocedure is time consuming, cumbersome, and can be inconsistent withrespect to the fit of the assembled dressing and the pressure applied bythe dressing to the wound site.

The current practice of preparing makeshift pressure dressings isinefficient, as it is time-consuming, averaging 3-5 minutes to assembleand apply a conventional pressure dressing, and can sometimes require asecond clinician's assistance. In addition, due to the custom-madenature of such dressings and the fact that different clinicians areconstructing and applying the dressings from one procedure to another,there can be significant differences in the pressure the dressings applyto the wound sites. Also, these makeshift pressure dressings can bebulky and unprofessional in appearance, and can also be uncomfortablefor the patient to wear and/or remove.

The disclosed devices address one or more of the issues noted above.

SUMMARY OF THE INVENTION

In order to address the shortcomings of makeshift pressure dressingsdiscussed above, a pre-assembled pressure bandage is provided. Thepre-assembled pressure bandage includes an elastic sheet having apredetermined shape and an adhesive side. The disclosed pressure bandagemay also include a resilient pad affixed to the elastic sheet. Theelasticity of the sheet and the resiliency of the pad cooperate toprovide the desired amount of pressure when the disclosed pressurebandage is applied to the wound site.

In one aspect, the present disclosure is directed to a pressure bandageincluding an elastic sheet having a first coefficient of elasticity andan adhesive side. The pressure bandage may also include a resilient padhaving a second coefficient of elasticity and affixed to the adhesiveside of the elastic sheet. The elastic sheet has a first predeterminedshape that is configured to be applied to a corresponding anatomicallocation on the body of a patient. The first coefficient of elasticityand the second coefficient of elasticity are related such that, when theelastic sheet is stretched and adhered to the body of the patient, theresilient pad applies a predetermined amount of pressure to the body ofthe patient.

In another aspect, the present disclosure is directed to a systemincluding an implantable medical device configured to be implantedproximate the surface of the skin, and a pressure bandage. The pressurebandage may include an elastic sheet having an adhesive side and aresilient pad affixed to the adhesive side of the elastic sheet. Theelastic sheet may have a first predetermined shape that is configured tobe applied to a corresponding anatomical location on the body of apatient.

In another aspect, the present disclosure is directed to a method ofapplying a pressure bandage to a patient. The method may includeapplying a pressure bandage to a surgical site at an anatomical locationof a patient, the surgical site including a surgically created pocket inwhich an implanted medical device is housed. Applying the pressurebandage to the patient applies a predetermined amount of pressure to thesurgical site. The pressure bandage may include an elastic sheet havingan adhesive side and a resilient pad affixed to the adhesive side of theelastic sheet. The elastic sheet may have a first predetermined shapethat is configured to be applied to a corresponding anatomical locationon the body of a patient. Applying the pressure bandage to the patientmay include positioning the resilient pad against the skin of thepatient over the location of the surgically created pocket.

Other systems, methods, features and advantages of the invention willbe, or will become, apparent to one of ordinary skill in the art uponexamination of the following figures and detailed description. It isintended that all such additional systems, methods, features andadvantages be included within this description and this summary, bewithin the scope of the invention, and be protected by the followingclaims.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention can be better understood with reference to the followingdrawings and description. The components in the figures are notnecessarily to scale, emphasis instead being placed upon illustratingthe principles of the invention. Moreover, in the figures, likereference numerals designate corresponding parts throughout thedifferent views.

FIG. 1 is a schematic perspective view of a pressure bandage accordingto an exemplary disclosed embodiment;

FIG. 2 is a schematic illustration of a medical device implanted in anabdomen of a patient;

FIG. 3 is a schematic cross-sectional illustration of a subcutaneousabdominal implant and surgical pocket taken at line 3-3 in FIG. 2 in aninferior direction;

FIG. 4 is a schematic illustration of a patient with an abdominal bulgeat an abdominal implant surgical site;

FIG. 5 is a schematic illustration of the patient shown in FIG. 4 withan exemplary pressure bandage applied to the abdominal surgical site;

FIG. 6 is a schematic illustration of a pressure bandage according to anexemplary disclosed embodiment;

FIG. 7 is a schematic illustration of the pressure bandage of FIG. 6showing cut lines of the liner;

FIG. 8 is a schematic illustration of a section of the liner beingpeeled off of the elastic sheet;

FIG. 9 is a schematic illustration showing the relative size of a pad ofa pressure bandage compared to the size of an exemplary implantablemedical device over which the pressure bandage may be applied;

FIG. 10 is a schematic illustration of a pressure bandage according toanother exemplary disclosed embodiment;

FIG. 11 is a schematic illustration of the patient shown in FIG. 4 withanother exemplary pressure bandage applied to the surgical site;

FIG. 12 is a schematic illustration of a patient with an implantablemedical device located in the lumber back region;

FIG. 13 is a schematic illustration of a patient with a bulge associatedwith a lumbar implant surgical site;

FIG. 14 is a schematic illustration of the patient shown in FIG. 13 withan exemplary pressure bandage applied to the lumbar surgical site;

FIG. 15 is a schematic illustration of a patient with a bulge associatedwith an upper chest implant surgical site;

FIG. 16 is a schematic illustration of the patient shown in FIG. 15 withan exemplary pressure bandage applied to the upper chest surgical site;

FIG. 17 is a schematic illustration of an anterior-lateral perspectiveview of a pressure bandage applied to the upper chest surgical site;

FIG. 18 is a schematic illustration of a femoral artery catheterinsertion site;

FIG. 19 is a schematic illustration of an embodiment of a pressurebandage applied to the femoral artery catheter insertion site shown inFIG. 18 ;

FIG. 20 is a schematic illustration of another embodiment of a pressurebandage applied to the femoral artery catheter insertion site shown inFIG. 18 ;

FIG. 21 is a schematic illustration of another embodiment of a pressurebandage applied to the femoral artery catheter insertion site shown inFIG. 18 ; and

FIG. 22 is a schematic illustration of another embodiment of a pressurebandage applied to the femoral artery catheter insertion site shown inFIG. 18 .

DETAILED DESCRIPTION

There are several processes by which fluids may collect in the tissuesof the body in the area of a wound site, whether the wound is incurredaccidentally via trauma or purposefully, such as by a surgicalprocedure. For surgeries that involve the implantation of a device(e.g., subcutaneously), the pocket formed in the tissue to receive thedevice may provide a cavity in which the fluids can collect, causingpain and swelling.

Via one physiological mechanism, the surgical procedure can damage bloodvessels in the tissue. If there are tears or other damage in the wallsof the blood vessels, blood can directly escape into the surroundingtissues. This can result in hematoma at the surgical site. A hematoma isa collection of blood in dead space in the body. A hematoma, whethercaused by trauma or surgery, can be caused by a small blood vessel beingopened to the surrounding tissue. Hematomas may sometimes need to bedrained because they can be painful, lead to scarring, and causeinfection.

A seroma is a collection of fluid around a surgery site, caused bydamage to the blood and lymph vessels and surrounding tissue. The bodysenses that damage has been done and produces an inflammatory responseby flooding the area with a clear fluid.

Hemostasis is a process which causes bleeding to stop, meaning to keepblood within a damaged blood vessel (the opposite of hemostasis ishemorrhage). It is the first stage of wound healing. This involvescoagulation, blood changing from a liquid to a gel. Intact blood vesselsare central to moderating blood's tendency to form clots. Theendothelial cells of intact vessels prevent blood clotting with aheparin-like molecule and thrombomodulin and prevent plateletaggregation with nitric oxide and prostacyclin. When endothelial injuryoccurs, the endothelial cells stop secretion of coagulation andaggregation inhibitors and instead secrete von Willebrand factor whichinitiate the maintenance of hemostasis after injury. Hemostasis hasthree major steps: 1) vasoconstriction, 2) temporary blockage of a breakby a platelet plug, and 3) blood coagulation, or formation of a fibrinclot. These processes seal the hole until tissues are repaired.

To improve hemostasis, a pressure bandage may be used to at leastpartially collapse damaged blood vessels in the subcutaneous tissues inorder to allow platelet aggregation, plug formation, and formation of afibrin clot. This prevents blood or blood components from leaking out ofthe blood vessels and forming hematoma in the surrounding tissues.Similarly, exudate in subcutaneous tissue is also determined by acombination of oncotic and hydrostatic pressure. Thus, pressure bandagesmay also be used to decrease seroma formation from exudate.

In another physiological mechanism, due to the body's inflammatoryresponse, the permeability of blood vessel walls increases, allowingfluids, proteins, and white blood cells (leukocytes) to escape throughthe vessel walls between the endothelial cells. These blood componentsform exudate that accumulates in the tissue at the surgical site. Ifthis exudate is not prevented or readily managed, a seroma can form.

In order to prevent or minimize the collection of fluids, the presentdisclosure provides a pressure bandage configured to apply apredetermined amount of pressure to a wound site. The pressure bandageincludes an elastic sheet having a first coefficient of elasticity andan adhesive side. The bandage also includes a resilient pad having asecond coefficient of elasticity and affixed to the adhesive side of theelastic sheet. The first coefficient of elasticity and the secondcoefficient of elasticity are related such that, when the elastic sheetis stretched and adhered to the body of the patient, the resilient padapplies a predetermined amount of pressure to the body of the patient.The predetermined amount of pressure is in a range that prevents orminimizes the escape blood from damaged blood vessels and the passage ofexudate through the walls of blood vessels, thereby preventing orminimizing the collection of fluids at the wound site.

FIG. 1 is a schematic perspective view of a pressure bandage accordingto an exemplary disclosed embodiment. FIG. 1 shows a pressure bandage100, which may include an elastic sheet 105 and a resilient pad 110. InFIG. 1 , the pressure bandage is upside down in order to show a skincontacting lower side 106 of resilient pad 110. As shown in FIG. 1 ,bandage 100 may have a substantially triangular shape, including a firstanchor 115 at a first vertex of the triangular shape, a second anchor120 at a second vertex of the triangular shape, and a third anchor 125at a third vertex of the triangular shape.

In addition, elastic sheet 105 may have a skin contacting lower surface135. Skin contacting lower surface 135 may include an adhesiveconfigured to adhere to the skin of a patient. In order to facilitatestorage and application of bandage 100, a liner 130 (e.g., releasepaper) may be affixed to the skin-contacting lower surface 135 (i.e. theadhesive side) of elastic sheet 105. In some embodiments, liner 130 mayinclude a plurality of cut lines 140 separating liner 130 into distinctsections, wherein cut lines 140 are configured to facilitate removingthe distinct sections of liner 130 in a predetermined sequence. Theconfiguration of liner 130 and cut lines 140 is discussed in furtherdetail below with respect to FIG. 7 .

In some embodiments, elastic sheet 105 and/or resilient pad 110 ofpressure bandage 100 may have a predetermined shape that is configuredto be applied to a corresponding anatomical location on the body of apatient. For example, in some embodiments, pressure bandage 100 may beconfigured for application in an abdominal region, an upper chestregion, a lumbar back region, an inguinal crease region, or any otherregion in which it would be desirable to apply a pressure bandage.

In some embodiments, pressure bandage 100 may be configured forapplication to a lower abdominal region of the patient. Further, in somecases, pressure bandage 100 may be configured for application to asurgical site in the lower abdominal region. Such a surgical site mayinclude surgical wounds from procedures such as gastric surgeries,appendectomies, hernia surgeries, cesarean sections (C-sections), orsubcutaneous device implantations.

In some embodiments, pressure bandage 100 may be configured forapplication to the site of a surgical pocket created for implantationsof medical devices. FIG. 2 is a schematic illustration of a medicaldevice 200 implanted in an abdomen 205 of a patient. As shown in FIG. 2, abdominal region 205 is defined, at least in part by a ribcage 210located superior to abdominal region 205, a pelvis 220 located inferiorto abdominal region 205, and a spinal column 215 located posterior toabdominal region 205.

The implantable medical device 200 may have one or more leads 222extending from the main body of the implant and extending to nearbyportions of the body. For example, as shown in FIG. 2 , lead 222 mayextend to spinal column 215. In some embodiments lead 222 may be aconduit configured to deliver a drug, such as pain medication to a partof the body, such as the cerebrospinal fluid. In such embodiments,medical device 200 may be a pump for delivering pain medication, andthus, may sometimes be referred to as a “pain pump.” In otherembodiments, lead 222 may include electrical leads configured forelectrical stimulation. Such leads may be extended to muscles or nervesto provide electrical stimulation.

In other embodiments, different types of medical devices may beimplanted in the lower abdominal region. Such devices may have differentsizes or shapes. Such devices may be positioned to the left or right ofthe anatomical center of the body. For example, device 200 is shown inFIG. 2 as being implanted in the left side of the patient's abdomen.Pressure bandage 100 may be configured for application to the wound sitefor any of the various possible configurations of the implantablemedical device.

In some embodiments, the medical device and pressure bandage may be partof a system wherein the two components are configured to work with oneanother. That is, the bandage may be sized and shaped to be applied tothe particular anatomical area of the body in which the medical deviceis designed to be implanted. In addition, the resilient pad may be sizedand shaped to cover an area substantially the same size and shape as themedical device. Thus, the resilient pad may be sized and shaped tosubstantially cover an area the size and shape as the surgical pocketinto which the medical device is configured to be implanted.

In some embodiments, the pressure bandage may be configured forapplication to surgical sites created by procedures involving theinsertion of subcutaneous implants. FIG. 3 is a schematiccross-sectional illustration of a subcutaneous abdominal implant andsurgical pocket taken at line 3-3 in FIG. 2 . In particular, FIG. 3shows implant 200 being inserted into a surgical pocket 265 in theabdominal region 205 of a patient through an outer surface 225 of theabdomen. FIG. 3 shows a flap 228 of tissue formed of skin 230 andsubcutaneous tissue 235 under which implant 200 is being inserted. Flap228 will be replaced over implant 200 and the incision closed. Forreference, abdominal muscles and associated tissues are also shown inFIG. 2 , including the external oblique 240, the internal oblique 245,the transverse abdominis 250, the rectus abdominis 255, and the rectussheath 260.

In some cases, the implantable medical devices may have a thickness suchthat a bulge is created in the patient's tissues when the device isimplanted. FIG. 4 is a schematic illustration of a patient 400 with anabdominal bulge 405 at an abdominal implant surgical site in abdominalregion 205. FIG. 5 is a schematic illustration of the patient shown inFIG. 4 with an exemplary pressure bandage applied to the abdominalsurgical site. As shown, pressure bandage 100 may be applied to thesurgical site. First anchor 115 may be adhered in the upper portion ofabdominal region 205. Second anchor 120 may be adhered around thepatient's lateral torso, above the hip. In addition, third anchor 125may be adhered across the central part of abdominal region 205. As shownin FIG. 5 , pressure bandage 100 may be positioned so that resilient pad110 may be located over the surgical pocket.

As illustrated in FIG. 5 , elastic sheet 105 of pressure bandage 100 maybe stretched firmly when pressure bandage 100 is applied to the body ofpatient 400. By pulling the anchors of pressure bandage 100 firmly whenapplying the bandage to the body, resilient pad 110 is pressed againstthe skin over the surgical pocket. The compressibility of resilient pad110 enables resilient pad 100 to match the contours of the implantedmedical device and the bulge in the abdomen created by the implanteddevice. Accordingly, resilient pad 110 is compressed against the skin byelastic sheet 105. Further, due to the resiliency of resilient pad 110,the compressed pad is biased to expand to its original, uncompressedcondition. Accordingly, the compressed pad's bias to expansion appliespressure to the wound site.

The elasticity of elastic sheet 105 and the resiliency of resilient pad110 may be configured to work in concert to produce a predeterminedamount of pressure against the outer surface of the skin, and thus,produce a predetermined amount of pressure against the blood vessels ofthe tissues at the wound site. For example, elastic sheet 105 may have afirst coefficient of elasticity and resilient pad 110 may have a secondcoefficient of elasticity. The first coefficient of elasticity and thesecond coefficient of elasticity may be related such that, when theelastic sheet is stretched and adhered to the body of the patient, theresilient pad applies a predetermined amount of pressure to the body ofthe patient.

Elastic sheet 105 may be formed of any suitable elastic sheet material.For example, in some embodiments, elastic sheet 105 may be formed of 3M™Tan Hi Tack Nonwoven Medical Tape, product number 9904. This material isan elastic nonwoven tape with a tan polyurethane nonwoven backing and anacrylate adhesive developed for medical use. The liner or release paperis a silicone coated on both sides. The elongation in the machinedirection (MD) is at least 300% minimum. The tensile break strength ofthis material, in the machine direction, is at least 4 lbs./inch ofwidth.

Resilient pad 110 may be formed of any suitable resilient material. Forexample, in some embodiments, resilient pad 110 may be formed ofviscoelastic foam, such as product number 6032 by Bergad, Inc. Thismaterial has an indentation forced deflection of 52 lb-ft. for 25%deflection. Compression set is less than 0.3% at 25% compression, and0.5% at 50% compression. In some embodiments, product 6030 from Bergad,Inc. may be used. Product 6030 is another viscoelastic foam, but is morefirm than product 6032. In particular, product 6030 has an indentationforced deflection of 68 lb-ft. for 25% deflection, compared to 52 lb-ft.for product 6032. The use of the softer foam may enable the pad tobetter conform to irregular shapes and/or edges of implants. When theimplantable device has a sharp peripheral edge and/or when the bulge ofthe implanted device protrudes significantly, the softer pad may betterconform around the form of the device, thus enabling pressure to beapplied consistently across the pocket. In some embodiments, the firmerpad may be selected in order to apply a higher overall amount ofpressure to the wound site.

In some embodiments, the predetermined amount of pressure applied by thepressure bandage when applied to the anatomical location on the body ofthe patient reduces or eliminates blood flow in venous capillaries ofthe patient. In some cases, the predetermined amount of pressure exertedby the pressure bandage when applied in the anatomical location on thebody of the patient applies a pressure against the patient's bloodvessels in the anatomical location of at least approximately 8 mmHG.

In some cases, the predetermined amount of pressure exerted by thepressure bandage when applied in the anatomical location on the body ofthe patient (i.e., on the external surface of the patient's body) may bein the range of approximately 5-30 mmHG. In some cases, thepredetermined amount of external pressure may be in the range ofapproximately 10-25 mmHG. In some embodiments, the predetermined amountof external pressure may be in the range of approximately 15-20 mmHG.Alternatively, in some embodiments, the predetermined amount of externalpressure may be in the range of approximately 5-15 mmHG.

In some embodiments, the resilient pad and the central portion of theelastic sheet may have substantially the same shape, with the centralportion of the elastic sheet being larger than the resilient pad. Thismay ensure that the elastic sheet can adhere to the skin of the patientaround the resilient pad on all sides.

FIG. 6 is another schematic illustration of pressure bandage 100. Asshown in FIG. 6 , resilient pad 110 may be generally centered on elasticsheet 105. Further, in some embodiments, resilient pad 110 may have asubstantially similar shape as elastic sheet 105. That is, in someembodiments, elastic sheet 105 may have a center portion with a firstpredetermined shape. For example, as shown in FIG. 6 , in someembodiments, the center portion of elastic sheet 105 may besubstantially triangular. The substantially triangular shape of thecenter portion of elastic sheet 105 may be formed by a first side edge671 extending between first anchor 115 and second anchor 120, a secondside edge 672 extending between second anchor 120 and third anchor 125,and a third side edge 673 extending between third anchor 125 and firstanchor 115. In addition, resilient pad 110 may include peripheral edgesforming a second predetermined shape. In some embodiments, the secondpredetermined shape may be substantially the same as the firstpredetermined shape of resilient pad 110 but larger. Accordingly, insome embodiments, resilient pad 110 may have a substantially triangularshape formed by a first pad edge 661, a second pad edge 662, and a thirdpad edge 663.

Further, in some embodiments, resilient pad 110 may be substantiallycentered on elastic sheet 105. That is, the peripheral edges ofresilient pad 110 may be substantially equally spaced from the outeredges of the center portion of elastic sheet 105. Accordingly, firstside edge 671 of elastic sheet 105 may be spaced from first pad edge 661by a first distance 681. Second side edge 672 may be spaced from secondpad edge 662 by a second distance 682. Third side edge 673 may be spacedfrom third pad edge 663 by a third distance 683. In some embodiments,pressure bandage 100 may have lateral symmetry. In such embodiments,first distance 681 may be substantially the same as third distance 683.In some embodiments, third distance 681 may also be substantially thesame as first distance 681 and third distance 683.

Pressure bandage 100 may also include skin anchors extending radiallyaway from resilient pad 110. For triangular configurations, such aspressure bandage 100 shown in FIG. 6 , skin anchors may be formed bylobes extending from the vertices of the triangular center portion ofelastic sheet 105. Accordingly, first anchor 115 is formed by a firstlobe extending from a first vertex between first outer edge 671 andthird outer edge 673. Second anchor 120 is formed by a second lobeextending from a second vertex between first outer edge 671 and secondouter edge 672. Third anchor 125 is formed by a third lobe extendingfrom a third vertex between the second outer edge 672 and third outeredge 673.

FIG. 6 schematically illustrates the general shape of pressure bandage100. Elastic sheet 105 may have a sheet width 640 and a sheet length645. Resilient pad 110 may have a pad width 650 and a pad length 655. Inaddition, resilient pad 110 may have a pad thickness 657 (see FIG. 8 ).First anchor 115 has a first width 605 and a first length 610. Inaddition, first anchor 115 may extend a distance 620 from peripheraledge 660 of resilient pad 110.

As shown in FIG. 6 , first anchor 115 may have a relatively large width605. This may provide a large surface area for anchoring pressurebandage 100 to the skin in the superior direction relative to the woundsite. Accordingly, first anchor 115 is subjected not only to tension dueto the stretching of elastic sheet 105 during application, but is alsoto tension resulting from the force of gravity pulling the rest ofpressure bandage 100 in the inferior direction. Also, as explained ingreater detail below, pressure bandage 100 may be configured tofacilitate applying first anchor 115 to the skin prior to applyingsecond anchor 120 and third anchor 125. With only first anchor 115 (andpossibly a portion of the center portion of elastic sheet 105) attachedto the skin, first anchor 115 may be subjected to a large amount oftension that is not necessarily experienced when all three anchors areaffixed to the skin. In order to ensure that first anchor 115 remainsaffixed to the skin when subjected to this large tension, first anchor115 is formed with a large surface area.

In addition, the neck region between first anchor 115 and the centerportion of elastic sheet 105 may have a neck width 615. Neck width 615may be selected to provide first anchor 115 with a tensile strength highenough to withstand the large tensile forces discussed above.

In addition, as will be discussed in greater detail below, pressurebandage 100 (or similarly shaped pressure bandages) may be applied tothe upper chest region of the patient. In such embodiments, first anchor115 may be configured to be affixed over the shoulder of the patient. Insuch embodiments, the width of first anchor 115 may provide a largesurface area to strengthen the connection of first anchor 115 to theupper back region of the patient. In addition, in such embodiments, neckwidth 615 may be formed narrow enough so as to avoid undue impingementon the patient's neck in the collar region.

As shown in FIG. 6 , second anchor 120 may have a second width 625extending from the intersection of second anchor 120 with first outeredge 671 and second outer edge 672. In addition, second anchor 120 mayhave a second length 630 extending radially from first outer edge 671and second outer edge 672. Further, second anchor 120 may extend adistance 635 from resilient pad 110. Although not labeled in FIG. 6 ,third anchor 125 may have the same or similar dimensions as secondanchor 120. Thus, as shown in FIG. 6 , first anchor 115 may have a firstanchor shape, second anchor 120 may have a second anchor shape, andthird anchor 125 may have a third anchor shape. As further shown in FIG.6 , second anchor 120 and third anchor 125 may have the same orsubstantially similar shape. As also shown in FIG. 6 , first anchor 115may have a substantially different shape than second anchor 120 andthird anchor 125.

It will be noted that the lateral symmetry of pressure bandage 100 shownin FIG. 6 may enable pressure bandage 100 to be applied to either sideof the body. In some embodiments, the pressure bandage may have alaterally asymmetric configuration in order to optimize application toone side of the body or the other.

In some embodiments, the liner or liner applied to the adhesive side ofthe elastic sheet may be configured to facilitate application of thepressure bandage. For example, in some embodiments, the liner mayinclude indicia indicating the orientation at which the pressure bandageshould be applied. Additionally, in some embodiments, the liner mayinclude a plurality of cut lines configured to facilitate removal ofsections of the liner in a particular order that provides application ofthe pressure bandage in the most consistent and effective way. In someembodiments, the cut lines may be configured with curves that facilitatepeeling the sections separated by the cut lines. Further, the liner mayinclude indicia, such as numbers, indicating the order in which thesections of liner should be removed, and thus the order in which theareas of the pressure bandage should be applied to the body of thepatient.

FIG. 7 is a schematic illustration of pressure bandage 100 showing liner130 affixed to the adhesive side of the elastic sheet. As shown in FIG.7 , liner 130 may include indicia, such as an orientation label 700. Asshown in FIG. 7 , orientation label 700 may indicate which side ofpressure bandage 100 should be oriented in the superior direction on thepatient. In bandages configured to be applied to other anatomicalregions of the body, different orientation labels may be used.

As also shown in FIG. 7 , liner 130 may include a plurality of cut linesseparating liner 130 into distinct sections. For example, as shown inFIG. 7 , liner 130 may be separated into a first section 701, a secondsection 702, a third section 703, a fourth section 704, a fifth section705, and a sixth section 706. First section 701 may include a firstindicia 711, second section 702 may include a second indicia 712, thirdsection 703 may include a third indicia 713, fourth section 704 mayinclude a fourth indicia 714, fifth section 705 may include a fifthindicia 715, and sixth section 706 may include a sixth indicia 716.First indicia 711, second indicia 712, third indicia 713, fourth indicia714, fifth indicia 715, and sixth indicia 716 may indicate a suggestedorder in which the sections of liner 130 should be removed.

Further, the cut lines may be configured to facilitate removing thedistinct sections of liner 130 in a predetermined sequence. For example,for applying a bandage having the shape of pressure bandage 100 to afront portion of the patient's torso, the upper portions of the bandagemay be affixed to the skin first. A first section 701 of liner 130should be removed first and the adhesive area of the elastic sheetcovered by first section 701 should be affixed to the skin first.Accordingly, first indicia 711 (shown, for example, in FIG. 7 as acircled “1”) may indicate that first section 701 should be removedfirst. By applying the portion of the bandage corresponding with firstsection 701 of liner 130 to the skin first, at least a portion of thebandage is held against and applied to the wound site before pulling anyanchors of the bandage, thus ensuring that the resilient pad ispositioned as desired over the wound site.

It will be noted that, while the resilient pad is not shown in FIG. 7 ,a dashed line 725 indicates the location of the peripheral edge of thepad. The inner edge 720 of liner 130 is shown in FIG. 7 to be slightlyspaced from dashed line 725. This slight spacing between inner edge 720of liner 130 and the peripheral edge of the resilient pad may facilitatethe removal of sections of liner 130 without binding against theperipheral edge of the resilient pad. In other embodiments, there may besubstantially no spacing between inner edge 720 of liner 130 and theperipheral edge of the resilient pad.

With the resilient pad held (by hand) against the wound site and thefirst section 701 of elastic sheet 105 held against the skin proximatethe wound site, first anchor 115 may be pulled radially away from theresilient pad and then affixed to the skin. While positioning thebandage to affix the section of elastic sheet 105 corresponding withfirst section 701 to the skin, a second section 702 of liner 130 may beleft attached to elastic sheet 105. This may facilitate handling anchor115 while orienting the bandage. Once the bandage is oriented and theportion of elastic sheet 105 corresponding with first section 701 isaffixed to the skin, second section 702 may be removed from first anchor115, then first anchor 115 may be pulled firmly, and first anchor 115may be affixed to the skin. A second indicia 712 may indicate thatsecond section 702 should be the next section of liner 130 removed.

In some embodiments, the cut lines between sections of liner may haveshapes that facilitate peeling the sections of liner in the desiredorder. For example, in some embodiments, the cut lines may have curvesthat form interlocking convex and concave portions. The convex portionsform tabs under which the user can place a finger or thumb in order tobegin peeling the section of liner off the elastic sheet. In someembodiments, the convex portions may be oriented in a direction thatfacilitates peeling when the bandage is in a predetermined conditionduring the bandage application process. That is, during the bandageapplication process, some portions of the bandage are adhered to theskin and other portions of the bandage are not. In order to facilitatepeeling of a given section of liner when the bandage is partiallyaffixed to the skin, a convex portion of the next section of liner to bepeeled may be oriented in a direction that makes the convex portion ofliner accessible when the bandage is partially affixed to the skin.

First section 701 and second section 702 of liner 130 may be separatedby a first cut line 730. First cut line 730 may have a curvedconfiguration defining interlocking convex and concave portions of liner130. For example, first section 701 of liner 130 may include a firstconvex portion 735 and a second convex portion 737 defined by first cutline 730. First convex portion 735 and second convex portion 737 mayinterlock with corresponding concave portions of second section 702 ofliner 130. In addition, first cut line 730 may also define a thirdconvex portion 738 of second section 702 of liner 130. The first placeto peel first section 701 may be first convex portion 735 (or secondconvex portion 737), which is located adjacent the peripheral edge ofelastic sheet 105. In addition, a second cut line 740 may define afourth convex portion 745 in first section 701 of liner 130 and a fifthconvex portion 750 in third section 703 of liner 130. Thus, the inferiorportion of first section 701 may be peeled beginning with fourth convexportion 745, which is located adjacent the peripheral edge of elasticsheet 105. Similarly, on the other side of pressure bandage 100, a thirdcut line 750 may define a sixth convex portion 755 of first section 701of liner 130 and a seventh convex portion 757 in fourth section 704 ofliner 130.

Once first section 701 of liner 130 is removed, and the section ofelastic sheet 105 is affixed to the skin as discussed above, secondsection 702 of liner 130 may be peeled from first anchor 115, beginningwith third convex portion 738. Then first anchor 115 may be pulledfirmly in a radial direction away from the resilient pad and affixed tothe skin.

At this point during the application process, first section 701 andsecond section 702 are affixed to the skin of the patient. Next, thirdsection 703 may be removed to begin the process of affixing secondanchor 120 to the skin. It will be noted that the order in which secondanchor 120 and third anchor 125 are applied may be reversed fordifferent applications. Generally, for off-center applications ofpressure bandage 100, application of the bandage can be facilitated andeffective if the anchor that will wrap around the side of the patient isapplied prior to the anchor that extends across the midline of thepatient's torso.

There are at least two reasons that this order of application may bebeneficial. First, postoperative patients are typically lying on theirbacks. This limits how far the anchor can be wrapped around thepatient's side. If the midline anchor is affixed first, and then theside anchor is pulled around the side of the patient, the hospital bedmay prevent the side anchor from being pulled far enough for theresilient pad to apply the magnitude of pressure that is desired.Accordingly, to ensure that the desired pressure is applied by thebandage, the side anchor may be affixed to the patient before themidline anchor. That is, the side anchor can be pulled as far around thepatient as desired, or as limited by the hospital bed. Then, the midlineanchor may be pulled across the patient's torso. The second reason forapplying the side anchor first is that, once the side anchor is affixedto the skin, the wrapping of the side anchor around the side of thepatient provides a secure attachment against which the midline anchormay be pulled across the torso. Accordingly, since the side anchor is tobe applied first, the description of FIG. 7 is for applying pressurebandage 100 off-center to the left side of the body.

As shown in FIG. 7 , third section 703 may include third indicia 713indicating the step at which third section 703 of liner 130 should beremoved. Third section 703 of liner 130 is defined by second cut line740, fourth cut line 760, and fifth cut line 770. Fourth cut line 760may define an eighth convex portion 765 in third section 703 and a ninthconvex portion 767 in fourth section 704 of liner 130. Fifth cut line770 may define a tenth convex portion 775 and an eleventh convex portion777 in third section 703. In addition, fifth cut line 770 may define atwelfth convex portion 778 in fifth section 705 of liner 130. In orderto peel third section 703 of liner 130, one or more of fifth convexportion 747, eighth convex portion 765, tenth convex portion 775, andeleventh convex portion 777 may be pulled. Each of eighth convex portion765, tenth convex portion 775, and eleventh convex portion 777 arelocated adjacent the peripheral edge of elastic sheet 105, which mayfacilitate placing a finger or thumb underneath these portions.

In some embodiments, the configuration of fourth cut line 760 may bereversed. By reversing cut line 760, the orientation of eighth convexportion 765 may also be reversed. This would facilitate removal offourth section 704 of liner 130 prior to third section 703. This, inturn, would facilitate application of fourth section 704 to the bodyprior to third section 703, which, as discussed above, may be suitablefor application of the pressure bandage off-center to the right of thepatient's torso, instead of off-center to the left.

Once third section 703 of liner 130 has been removed, the area ofelastic sheet 105 from which third section 703 was removed may beaffixed to the skin of the patient. With the areas of elastic sheet 105corresponding with first section 701, second section 702, and thirdsection 703 of liner 130.

At this point, a choice may be made as to the order in which theremaining sections of liner 130 are removed. The order may be chosenbased on the patient's anatomy, the type of implantable device overwhich the bandage is being applied, the location on the body that thebandage is applied, or the user's personal preference. Choices for thefinal sequence of liner removal include the following. In one possiblesequence, fourth section 704 may be removed, then fifth section 705,followed by sixth section 706. This sequence ensures secure fixationproximate the resilient pad prior to application of second anchor 120and third anchor 125. Another possible sequence may be to remove fourthsection 704, sixth section 706, and then fifth section 705. In somecase, this alternative may be efficient because the user can work withsixth section 706 immediately after fourth section 704 to which sixthsection 706 is adjacent. That is, the user will already be working withthat corner of the bandage (i.e., in fourth section 704), so staying inthat corner (i.e., with sixth section 706) enables the user to quicklytransition. As another possible sequence, after removing third section703 and affixing the corresponding portion of elastic sheet 105 to thebody, the user may then remove fifth section 705, then fourth section704, followed by sixth section 706. This may facilitate attachment ofsecond anchor 120 completely before moving to third anchor 125. Asdiscussed above, attaching the side anchor, which is second anchor 120in this case, has at least two particular benefits. It will beunderstood that the order in which sections of the liner are removed mayvary. Further, in some cases, more than one section of liner may beremoved at a time. In addition, the configuration of cut lines may varydepending on the size and shape of the bandage and/or depending on theanatomical location in which the bandage is to be used.

FIG. 8 is a schematic illustration of liner 130 being peeled fromelastic sheet 105. As shown in FIG. 8 , first concave portion 735 offirst section 701 of liner 130 is being peeled away from adhesivesurface 800 of elastic sheet 105.

Resilient pad 110 may be sized and shaped to provide pressure to asurgical pocket for differently shaped implantable devices. Resilientpad 110 need not necessarily have the same shape as the medical deviceover which it is applied. However, in some embodiments, it may bebeneficial if the skin contacting surface area of resilient pad 110 islarge enough to fully cover the medical device regardless of whether theresilient pad and the medical device have the same shape.

In some embodiments, a system may be provided including an implantablemedical device configured to be implanted at an anatomical locationproximate the surface of the skin; and a pressure bandage configured tobe applied to a surgical site from the implantation of the medicaldevice. For example, in some cases, the medical device may be configuredto be implanted subcutaneously. In other cases, the medical device maybe configured to be implanted submuscularly. In still other cases, themedical device may be configured to be implanted under other tissueslocated proximate to the skin. The pressure bandage may include anelastic sheet having a first predetermined shape that is configured tobe applied to the anatomical location at which the medical device isconfigured to be implanted. In addition, the implantable medical devicemay have a size that corresponds with a size of the resilient pad.

FIG. 9 is a schematic illustration showing the relative size and shapeof resilient pad 110 of pressure bandage 100 compared to the size andshape of an exemplary implantable medical device 900 over which pressurebandage 100 may be applied. Medical device 900, as shown in FIG. 9 , hasa hypothetical shape that is based loosely on the shapes of certaincommercially available implantable devices over which pressure bandage100 may be applied. Medical device 900 is intended to schematicallyillustrate an irregular shape relative to the substantially triangularshape of resilient pad 110. As shown in FIG. 9 , the outer periphery ofmedical device 900 may fall completely within the outer boundary ofresilient pad 110.

FIG. 10 is a schematic illustration of a pressure bandage according toanother exemplary disclosed embodiment. As shown in FIG. 10 , a pressurebandage 1000 may include an elastic sheet 1005 and a resilient pad 1010.The materials and general configurations of elastic sheet 1005 andresilient pad 1010 may be substantially similar to the embodiment shownin FIGS. 1-9 . Particular differences in the embodiment shown in FIG. 10include the precise shapes of elastic sheet 1005 and resilient pad 1010.Elastic sheet 1005 may have a first width 1055 and a first length 1060.First width 1055 and first length 1060 may be substantially similar tothe dimensions of elastic sheet 105. However, a first anchor 1015 mayhave an anchor width 1050 that is substantially wider than first anchor115 of elastic sheet 105. This wider anchor may facilitate applicationof pressure bandage 1000 to different portions of the body that mayrequire stronger fixation at the first anchor.

In addition, resilient pad 1010 may have a second width 1065 and asecond length 1075. While second width 1065 may be substantially similarto that of resilient pad 110, second length 1075 may be at leastslightly shorter than that of resilient pad 110. The shorter length ofresilient pad 1010 may lengthen the amount of adhesive surface areabetween resilient pad 1010 and the distal tip of first anchor 1015.

Also, as shown in FIG. 10 , the liner may have differently configuredcut lines. For example, a first cut line 1041 has additional curvesdefining more convex portions to the adjacent sections of the liner. Asecond cut line 1042 and a third cut line 1043 may each have a curvedportion and one or more straight portions. This may facilitate removalof the liner sections in varying order. For example, a cut line having astraight segment adjacent to the outer edge of the liner, wherein thesegment is perpendicular to the edge of the liner, may facilitatepeeling either of the adjacent liner sections before the other. Inaddition, a fourth cut line 1044 may have both additional convexportions and straight segments. This may increase the flexibility toremove the liner sections in varying ways and sequences.

Pressure bandages having significantly different shapes may alsoimplement similar principles to those discussed above. For example, insome embodiments, the elastic sheet and/or the resilient pad may besubstantially circular. In addition, a widened anchor may be used foranatomical locations other than the superior portion of the bandage, andpossibly in more than one location on the same bandage.

FIG. 11 is a schematic illustration of the patient shown in FIG. 4 withanother exemplary pressure bandage applied to the surgical site. Asshown in FIG. 11 , a pressure bandage 1100 may be applied to abdominalregion 205 of patient 400. As further shown in FIG. 11 , pressurebandage 1100 may include an elastic sheet 1105 and a resilient pad 1110.Both elastic sheet 1105 and resilient pad 1110 may have substantiallycircular shapes. In addition, elastic sheet 1105 may include a firstanchor 1115 and a second anchor 1120 (shown wrapped around the side ofthe patient). As shown in FIG. 11 , first anchor 1115 may have a widenedshape. Although not shown in FIG. 11 , second anchor 1120 may also havethe same or similar widened shape. With only two anchors, the additionalsurface area of widened anchors may provide improved fixation adhesionto compensate for having one fewer anchor.

Pressure bandages with the same or similar configurations may be appliedto different portions of the body. For example, pressure bandagesconfigured for application in the lower abdominal region may besimilarly applied to the lower lumbar region.

FIG. 12 is a schematic illustration of a patient with an implantablemedical device located in the lumbar back region. As shown in FIG. 12 ,a lumbar medical implant 1200 implanted in the lower lumbar region 1205.Implant 1200 may include a lead 1222, which may deliver either fluidand/or may include electrical leads for administering electrotherapy.

FIG. 13 is a schematic illustration of patient 400 with a bulge 1210associated with the lumbar implant surgical site in which implant 1200may be implanted. It will be noted that implant 1200 may be inserted oneither side of lower lumbar region 1205.

FIG. 14 is a schematic illustration of patient 400 with pressure bandage100 applied to the lumbar surgical site. As shown in FIG. 14 , pressurebandage 100 may be applied to the lower lumbar region in a similar wayas it is applied to the lower abdominal region. In particular, firstanchor 115 is located in a superior position, second anchor 120 may bewrapped around the side of the patient, and third anchor 120 may extendlaterally across the midline of the patient's torso.

FIG. 15 is a schematic illustration of patient 400 with a bulge 1505associated with an upper chest implant surgical site. Exemplaryimplantable medical devices that may be implanted in the upper chestregion include pacemakers, defibrillators, medication injection ports,and other various implantable devices.

FIG. 16 and FIG. 17 are schematic illustrations of patient 400 withpressure bandage 100 applied to the upper chest surgical site shown inFIG. 15 . As shown in FIGS. 16 and 17 , first anchor 115 of pressurebandage 100 may be applied over the patient's shoulder. Second anchor120 may be wrapped around the side of the patient, under the patient'sarm. Third anchor 125 may extend across the midline of the patient'storso. Accordingly, the process of applying pressure bandage 100 to theupper chest region may be substantially similar to the process ofapplying pressure bandage 100 to the lower abdominal region discussedabove.

The application of pressure bandages such as those discussed above mayenable a predictable amount of pressure to be applied by the bandage,and the bandage may be applied much more quickly than makeshift pressuredressings formed of multiple pieces of gauze padding and several stripsof medical tape.

In some embodiments, pressure bandages having similar property as theembodiments discussed above may be utilized for surgical sites that donot include a surgical pocket or an implanted device. One exemplary suchsurgical site is the femoral artery insertion site for cardiaccatheters. FIG. 18 is a schematic illustration of a femoral arterycatheter insertion site 1800. As shown in FIG. 18 , a catheter 1805 maybe inserted into a femoral artery 1805 in a generally superior directionindicated by an arrow 1815. As further shown in FIG. 18 , insertion site1800 falls approximately in the inguinal crease 1820 of the patient,which is the crease between the lower abdomen and the upper thighregions of the patient.

Following catheterization procedures, after the catheter has beenremoved from the femoral artery, pressure must be held on the insertionsite for a period of time to ensure that blood does not leak out of thehole made in the femoral artery into the surrounding tissue, which wouldcause a hematoma. In order to apply this pressure, various methods aretypically used. In some cases, a doctor or nurse literally holdspressure with their own hand for twenty minutes or more. This is becausethe femoral artery insertion site for catheters is in a recess in theouter surface of the body and bandages do not apply a significant amountof pressure to the wound site.

The femoral artery insertion site for catheters is in the inguinalcrease, which runs from the iliac crest of the pelvis to the pubic bonein the crotch of the patient. The inguinal crease is recessed below thesurfaces of the abdomen and the upper thigh. Therefore, even a makeshiftpressure dressing applied in this area would not apply much pressure tothe insertion site. Therefore, the physician or nurse must apply thepressure by hand. Various types of devices have been developed to applypressure in this location. But most are cumbersome, overly complicated,or generally ineffective. Because of the thickness and resilience of thepads used for the pressure bandages disclosed herein, pressure may beapplied even in a recessed surgical site, such as the inguinal crease.

FIG. 19 is a schematic illustration of an embodiment of a pressurebandage applied to the femoral artery catheter insertion site shown inFIG. 18 . As shown in FIG. 19 , a pressure bandage 1900 may include anelastic sheet 1905 and a resilient pad 1910. The properties andcharacteristics of elastic sheet 1905 and resilient pad 1910 may besubstantially similar to the corresponding components in the embodimentsdiscussed above. For example, elastic sheet 1905 may have asubstantially triangular shape. However, in some embodiments, resilientpad 1910 may have a substantially rectangular shape, which may beelongated in a direction along the inguinal crease. This elongated padmay facilitate the application of pressure into the recess of inguinalcrease 1820.

The relative scale of pressure bandage 1900 may be generally smallerthan that of the embodiments discussed above, simply due to theanatomical area being smaller than the lower abdominal, lower lumbar,and upper chest regions discussed above. Further, pressure bandage 1900may employ a liner having cut lines to facilitate application of thebandage, as discussed above with respect to other disclosed embodiments.

In addition, pressure bandage 1900 may include a first anchor 1915,which may be configured to be applied with an orientation extending in asuperior-lateral direction along inguinal crease 1820. Pressure bandage1900 may also include a second anchor 1920 and a third anchor 1925extending in generally opposite directions across inguinal crease 1820.In addition, pressure bandage 1900 may include a fourth anchor 1930extending opposite first anchor 1915 in an inferior-medial direction.Depending on the patient's anatomy, in some cases, pressure bandage 1900may be applied in an orientation that is 180 degrees from that shown inFIG. 19 . That is, first anchor 1915 may extend in the inferior-medialdirection along inguinal crease 1820 and fourth anchor 1930 may extendin the superior-lateral direction along inguinal crease 1820.

FIG. 20 is a schematic illustration of another embodiment of a pressurebandage applied to the femoral artery catheter insertion site shown inFIG. 18 . In particular, FIG. 20 shows a pressure bandage 2000 includingan elastic sheet 2005 and a resilient pad 2010. As shown in FIG. 20 ,elastic sheet 2010 may have a substantially similar configuration toelastic sheet 110 of pressure bandage 100 discussed above. For example,elastic sheet 2010 may have a substantially triangular shape and mayinclude a widened first anchor 2015, a second anchor 2020, and a thirdanchor 2025. As shown in FIG. 20 , in some embodiments, resilient pad2010 may have a substantially circular shape. The substantially circularpad may facilitate applying pressure to a relatively small wound siteconsisting of a point at which an artery was punctured by a needle andthrough which a catheter was inserted and removed.

FIG. 21 is a schematic illustration of another embodiment of a pressurebandage applied to the femoral artery catheter insertion site shown inFIG. 18 . As shown in FIG. 21 , a pressure bandage 2100 may include anelastic sheet 2105 and a resilient pad 2110. Elastic sheet 2105 andresilient pad 2110 may have similar properties and characteristics ascorresponding components in the embodiments discussed above. As shown inFIG. 21 , resilient pad 2110 may have a substantially circular shape.Elastic sheet 2105 may have an elongate teardrop shape formed of a firstanchor 2115 and a second anchor 2120. To form the elongate teardropfirst anchor 2115 may be wider than second anchor 2120. The wider firstanchor 2115 may facilitate fixation across inguinal crease 1820 in theupper region where the crease is not sharply creased, whereas the moreslender second anchor 2120 may facilitate application to the lowerportion of inguinal crease 1820, which is a much tighter area in whichto apply a bandage.

FIG. 22 is a schematic illustration of another embodiment of a pressurebandage applied to the femoral artery catheter insertion site shown inFIG. 18 . As shown in FIG. 22 , a pressure bandage 2200 may include anelastic sheet 2205 and a resilient pad 2210. Elastic sheet 2205 andresilient pad 2210 may have similar properties and characteristics ascorresponding components in the embodiments discussed above. As shown inFIG. 22 , resilient pad 2210 may have a substantially circular shape.Elastic sheet 2205 may have an elongate curved shape, such as a kidneybean shape, as shown in FIG. 22 . At one end, elastic sheet 2205 mayhave a first anchor 2215. At the opposite end, elastic sheet 2205 mayinclude a second anchor 2220. The curvature of elastic sheet 2205 mayfacilitate application to the insertion site for patients who have asubstantially curved inguinal crease 1820. That is, the curvature of thekidney bean shape may better follow the curved contour of the upper leg.In some cases, a pressure bandage having the same or similar shape asshown in FIG. 22 may be used for cesarean-section (C-section) incisions.Such a kidney bean shape may be particularly suitable for curvedC-section incisions, such as the Maylard incision and the Pfannenstielincision.

While various embodiments of the invention have been described, thedescription is intended to be exemplary, rather than limiting and itwill be apparent to those of ordinary skill in the art that many moreembodiments and implementations are possible that are within the scopeof the invention. Accordingly, the invention is not to be restrictedexcept in light of the attached claims and their equivalents. Also,various modifications and changes may be made within the scope of theattached claims.

We claim:
 1. A pressure bandage, comprising: an elastic sheet having afirst coefficient of elasticity and an adhesive side; a resilient padhaving a first side affixed to the adhesive side of the elastic sheetand a second, patient-contacting side opposite the first side and havinga second coefficient of elasticity, such that the second,patient-contacting side is compressible and resilient; wherein theelastic sheet has a first predetermined shape that is configured to beapplied to a corresponding anatomical location on the body of a patient;wherein the first coefficient of elasticity and the second coefficientof elasticity are related such that, when the elastic sheet is stretchedand adhered to the body of the patient, the patient-contacting side ofthe resilient pad compresses and applies a predetermined amount ofpressure to the body of the patient; wherein the predetermined amount ofpressure applied by the pressure bandage when applied to the anatomicallocation on the body of the patient reduces or eliminates blood flow inblood vessels of the patient in an area of a patient corresponding to asurgical pocket of an implanted device; wherein the elastic sheet isconfigured to be adhesively applied to the skin of a patient, completelysurrounding the resilient pad; and wherein the resilient pad is formedof a viscoelastic foam having a compressibility that enables theresilient pad to readily conform to contours of an implanted medicaldevice bulging under the skin of a patient.
 2. The pressure bandage ofclaim 1, wherein the predetermined amount of pressure applied by thepressure bandage when applied to the anatomical location on the body ofthe patient reduces or eliminates blood flow in capillary vessels of thepatient.
 3. The pressure bandage of claim 1, wherein the predeterminedamount of pressure exerted by the pressure bandage when applied in theanatomical location on the body of the patient applies a pressureagainst the patient's blood vessels in the anatomical location of atleast approximately 8 mmHG.
 4. The pressure bandage of claim 1, whereinthe predetermined amount of pressure exerted by the pressure bandagewhen applied in the anatomical location on the body of the patient is inthe range of approximately 5-30 mmHG.
 5. The pressure bandage of claim4, wherein the predetermined amount of pressure is in the range ofapproximately 10-25 mmHG.
 6. The pressure bandage of claim 5, whereinthe predetermined amount of pressure is in the range of approximately15-20 mmHG.
 7. The pressure bandage of claim 5, wherein thepredetermined amount of pressure is in the range of approximately 5-15mmHG.
 8. The pressure bandage of claim 1, wherein the pressure bandageis configured to be applied to one or more of the following anatomicalregions of a patient: an abdominal region, an upper chest region, alumbar back region, and an inguinal crease region.
 9. The pressurebandage of claim 1, wherein the elastic sheet has a center portion witha second predetermined shape; wherein the resilient pad has peripheraledges forming a third predetermined shape; and wherein the centerportion of the elastic sheet has outer edges forming a shape that issubstantially the same as the third predetermined shape of the resilientpad but larger, such that peripheral edges of the resilient pad aresubstantially equally spaced from the outer edges of the center portionof the elastic sheet.
 10. The pressure bandage of claim 9, wherein thesecond predetermined shape is substantially triangular, and the thirdpredetermined shape is substantially triangular.
 11. The pressurebandage of claim 10, wherein the substantially triangular shape of thecenter portion of the pressure bandage includes a first outer edge, asecond outer edge, and a third outer edge; and wherein the firstpredetermined shape includes the substantially triangular shape of thecenter portion as well as a first lobe extending from a first vertexbetween the first outer edge and the second outer edge, a second lobeextending from a second vertex between the second outer edge and thethird outer edge, and a third lobe extending from a third vertex betweenthe third outer edge and the first outer edge.
 12. The pressure bandageof claim 11, wherein the first lobe forms a first elastic skin anchor,the second lobe forms a second elastic skin anchor, and the third lobeforms a third elastic skin anchor.
 13. The pressure bandage of claim 12,wherein the first elastic skin anchor has a first anchor shape and thesecond elastic skin anchor has a second anchor shape that is differentfrom the first anchor shape.
 14. The pressure bandage of claim 1,further including a liner affixed to the adhesive side of the elasticsheet and including a plurality of cut lines separating the liner intodistinct sections, wherein the cut lines are configured to facilitateremoving the distinct sections of the liner in a predetermined sequence.15. A pressure bandage, comprising: an elastic sheet having an adhesiveside; a resilient pad affixed to the adhesive side of the elastic sheet;wherein, when the elastic sheet is stretched and adhered to the body ofthe patient, the resilient pad applies a predetermined amount ofpressure to the body of the patient; and further including a lineraffixed to the adhesive side of the elastic sheet and including aplurality of cut lines separating the liner into distinct sections;wherein the plurality of cut lines are defined by abutting edges of thedistinct sections of the liner; wherein the liner covers no portion ofthe resilient pad; wherein the elastic sheet is substantiallytriangular, including an outer perimeter having a first set of threesides; wherein the resilient pad is substantially triangular, includingan outer perimeter having a second set of three sides, substantiallycorresponding respectively with the first set of three sides; whereinthe plurality of cut lines between the distinct sections of the linerinclude three cut lines respectively extending from the second set ofthree sides of the outer perimeter of the resilient pad to the first setof three sides of the outer perimeter of the elastic sheet.
 16. Thepressure bandage of claim 15, wherein the predetermined amount ofpressure applied by the pressure bandage when applied to the body of thepatient reduces or eliminates blood flow in capillary vessels of thepatient.
 17. The pressure bandage of claim 15, wherein the predeterminedamount of pressure exerted by the pressure bandage when applied on thebody of the patient applies a pressure against the patient's bloodvessels in the anatomical location of at least approximately 8 mmHG. 18.The pressure bandage of claim 15, wherein the predetermined amount ofpressure exerted by the pressure bandage when applied on the body of thepatient is in the range of approximately 5-30 mmHG.
 19. The pressurebandage of claim 18, wherein the predetermined amount of pressure is inthe range of approximately 10-25 mmHG.
 20. The pressure bandage of claim15, wherein the pressure bandage is configured to be applied to one ormore of the following anatomical regions of a patient: an abdominalregion, an upper chest region, a lumbar back region, and an inguinalcrease region.